Download SUCCESSFUL SCHOOL HEALTH SERVICES FOR YOUNG PEOPLE

Successful School Health Services for Young People
Implications for service delivery
The following implications for service delivery have been distilled from the literature and
consultation with youth health sector in New Zealand. They are designed to support the
achievement of the four critical areas of success factors identified by this review
1. Wide engagement with school and
community
 Early formation of an advisory board
with
community
and
school
representation.
The advisory board
should reflect the diversity of the school
community.
 Consultation
within
the
school
including: principal, staff, school
pastoral team, Board of Trustees,
students and parents.
Consultation
beyond the school including iwi and
PHO’s or GP’s in the school zone.
 Stocktake of existing services in the
school and wider community. Ongoing
co-ordination and integration with these
services.
 Mutually
agreed
roles
and
responsibilities of each party – the
school and the school based health
service – drafted into a formal
agreement.
This should include
reference to relevant school policies,
financial arrangements, facilities to be
provided by the school, key contact
people for each organization, liability
coverage of each party, and reporting
requirements.
 Commitment to communicate on a
regular basis between all staff providing
health and support services in the
school. This would include both case
review (usually fortnightly or weekly)
and service development meetings (e.g.
quarterly)
 Health service personnel aware of the
school’s
health
curriculum,
and
available
to
contribute
where
requested.
 Health service working closely with
education staff to identify and assist
those students with issues influencing
their educational performance.
 Health service staff available to
contribute to whole school approaches
for improving student health and wellbeing.
 Ongoing communication with the school
and the wider community e.g.
presentations at school assemblies,
involvement in health classes, presence
of staff at school meetings, newsletters,
visits for new students.
2. Youth focus and participation
 All school-based health services have or
utilise a youth advisory group.
 Known youth health
addressed including
access
issues
o
Youth friendly staff who genuinely
respect and enjoy working with
young people
o
Appropriate location of the service
o
Operating hours appropriate for the
needs of the students where
possible e.g. available over lunch
time
o
Confidentiality policies displayed
clearly in the waiting room and
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o
personally reiterated by health care
providers in their clinical contacts
development, quality and related policy
issues.
A youth friendly version of the
Patient Code of Rights on display
 Comprehensive opportunistic screening
for important adolescent health issues
offered to all young people receiving
care. In liaison with local primary care
providers, consideration should also be
given to offering regular health check
ups e.g. Yr 9, 11 and 13.
 Strategies to help raise both student
and parent awareness of available
services, and how to access them.
Information should be provided in
languages and in cultural settings
appropriate to the school community.
 Linkages developed with peer support
health initiatives in the school. For
instance involving peer supporters in
the health service (with adequate
training, supervision and clear roles).
3. Delivery
of
high
quality
comprehensive care.
 Cultural
needs
considered
and
addressed strategically, operationally
and clinically. This includes enhancing
cultural competence of staff and
supporting students’ connections to
their own cultures.
 Staff providing school-based services
maintaining
their
own
specific
professional
development
and
competencies, and regular professional
supervision. In addition staff should
have appropriate training in youth
health. For clinical leaders this should
include holding, or working towards, a
postgraduate qualification in Youth
Health.
 Given the potential for complex nursing
judgements to be required in the school
setting,
all
nurses
working
independently in the school setting
should be fully registered nurses.
 Staff have dedicated time and resource
available for collaboration, professional
 Screening, assessment and primary
care level mental health services
provided on site.
Ready access to
further mental health services where
necessary.
 Local guidelines for relevant clinical
practice
adopted,
along
with
establishment of a medical protocol and
procedure manual.
 Mechanisms and processes for the
exchange of medical information (with
student permission) between schoolbased providers and other services such
as the school pastoral team, student’s
family doctor or nurse and referral
agencies.
 Provision and dispensing of medicines
for common medical problems should
preferably be on-site with secure
storage of medications. Alternatively
school based health services should
arrange for medications to be available
free or at a subsidised rate from a
nearby pharmacy.
 Where a doctor is not on site or only
infrequently, consideration of the use of
standing orders.
These may be
arranged with local primary medical
care providers to allow dispensing of
some medication by appropriately
trained nursing staff.
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 Examination and treatment areas
comply with standard infection control
and safety regulations.
 Staff trained in general first aid,
including regular CPR updates.
An
emergency plan and appropriate easily
accessible equipment and drugs for
emergencies be available and regularly
checked for expiry.
4. Effective
administrative/clinical
systems,
and
governance
to
support service delivery.
 A functioning oversight committee
operating
with
sound
business
procedures and based on the Treaty of
Waitangi framework consistent with the
NZ Health Strategy.
 Appropriate written policies on consent,
confidentiality, collection and use of
health information, and protection of
records. These must be in line with the
New Zealand Public Health and
Disabilities Act 2000, and the Health
Information Privacy Code 1994.
 Systems to prompt screening, and
appropriate documentation of care,
along with tracking missed and followup appointments, and laboratory and
referral reports.
 A professional development strategy
recognizing the need for quality primary
care provision in addition to youth
specific issues.
 A system for gathering data on key
indicators of quality youth health
services.
 Monitoring
and
evaluating
appropriateness and accessibility of
services with regular surveys of
students/school/community.
 Service development based on periodic
review of data.
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